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Johns Hopkins Health Alert

Macular Degeneration Drug Update

Johns Hopkins Health Alerts | Vision | Macular Degeneration Drug Update

Dr. Susan Bressler talks about two new medications for age-related macular degeneration – Avastin and Lucentis.

Q. I’ve heard that new medications to treat wet age-related macular degeneration (AMD) are available. Are these new medications better than current treatments?

A. Two new medications—Avastin (bevacizumab) and Lucentis (ranibizumab) -- are now in use to treat macular degeneration. These new macular degeneration treatments are exciting because they offer the opportunity to slow vision loss and may restore vision, to a degree, in some people with wet macular degeneration. Older drugs for wet macular degeneration, like Macugen (pegaptanib), also offer the possibility of decreasing further vision loss but rarely lead to the restoration of vision.

Both new wet macular degeneration medications inhibit angiogenesis—the process by which the body creates new blood vessels. Wet macular degeneration is caused by the abnormal growth of blood vessels below the retina. These fragile vessels often burst, and blood, fluid, and the vessels themselves cause damage to the eye.

Avastin was approved by the FDA in 2004 for intravenous administration to treat colon cancer, but many ophthalmologists found that very small doses of it injected into the eye appeared effective against wet macular degeneration. Genentech, the company that produces Avastin, tested and reformulated the drug as a specific treatment for wet macular degeneration. The result is Lucentis, which was FDA approved for wet macular degeneration in June 2006.

Genentech claims the newer macular degeneration drug can more easily pass through the retina, but perhaps the biggest difference between the two Genentech drugs is their cost—a dose of Avastin for wet macular degeneration costs from $30–$200, while treatment with Lucentis can cost thousands of dollars. Medicare covers Lucentis, but it still may cost more than Avastin depending on your particular prescription plan.

Neither macular degeneration medication has a very long track record, so which one is the best choice? According to ophthalmologist Susan Bressler, MD., the Julia G. Levy, Ph.D., Professor of Ophthalmology at Johns Hopkins University School of Medicine, "The advantage of Lucentis is that its safety and efficacy in people with wet macular degeneration have been more firmly established than those of Avastin.” However, Dr. Bressler adds, “I would recommend Avastin for many individuals who have wet macular degeneration and cannot afford to receive Lucentis.” In 2007 the National Institutes of Health will begin ahead-to-head test of the two drugs.

According to Dr. Bressler, "Among the available treatment options, these two medications offer the greatest chance of stabilization or recovery of vision for wet macular degeneration patients.”

Johns Hopkins Health Alerts | Vision | Macular Degeneration Drug Update

Posted in Vision on February 2, 2007
Reviewed May 2007

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Users and editors may post comments here at their own discretion. The views expressed do not constitute medical advice and do not represent the position of Johns Hopkins Medicine or University Health Publishing, which has no responsibility for its content.


I am seeking information on "retinal vein occlusion," which seems similar to AMD. I'm wondering if the treatments for AMD could be applied to retinal vein occusioin, or if there are other treatments.

Posted by: eyelet | February 13, 2007

I have 2 friends that have this horrible disease that leads to blindness. They both have the DRY M.D. Is there any hope for them in drugs, treatment etc.????? What causes dry M.D.???? Thanks for your expertise, Dina Miller

Posted by: Dina | May 30, 2007

The 2007 Johns Hopkins White Paper has an informative section on macular degeneration. You could tell your friends to order it from this website at: http://www.johnshopkinshealthalerts.com/white_papers/vision_wp/digital_landing.html

Posted by: Marjorie | May 31, 2007

I have been receiving shots in my left eye for over a year with Macugen. When the new medication became available, my doctor switched and gave me about 3 treatments. He said that my eye was doing so good, he stopped giving me the treatments for the last three visits. He would give me a thorough exam of the eye, my next visit is scheduled for the 27th of this month (June 07). My vision has improved, the distortion is much smaller but enough that it interrupts the words in a sentence. White is brighter now with my left eye than my good eye. I do notice a shadow condition in my right eye in the very center of my vision. There is no destortion. I can read the 2nd last line at the bottom of the chart with my right eye. What is your recommendation? Prostrate Problem: this condition occured directly after I had a hernia operation. After a month, I went for a CT scan and the doctor gave me a thorouth exam. I don't have any problems, but I read in your report that once you start on Flomax (0.4 Mg), I must stay on the drug all my lift. Is there a way to wean off this drug? I was 80 years old last Dec. 27th and I have been taking CoQ10 for about 1-1/2 years. Prior to taking it, my blood pressure was very high. It is maintaining 120/70. My heart beat is 45 to 50, and has been like that all my life. My doctor did not see me for 3 years and after a complete physical, he told me I am better now than 3 years ago. He said he is going to start taking CoQ10. On the way out, I thought to myself, I should have charged him instead of him charging me! Stephen J. Novak, P.E., nova-139@juno.com PS I have passed on a lot of your information to people that appreciate your info. and I tell them to follow up by signing on at your web site. I do think you are doing great. Keep up the good work.

Posted by: STEPHEN J. NOVAK, P.E. | June 9, 2007

I have your latest 2007 White Papers on Vision and Prostrate. nova-139@juno.com I did send questions in just prior to this note. I am looking for your opinion on my condition.

nova-139@juno.com

Posted by: STEPHEN J. NOVAK, P.E. | June 9, 2007



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